Browsing by Author "Beutelspacher, Friedrich"

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    Development and application of insulin infusion profiles for therapy of type I diabetics with portable insulin infusion systems
    (1984) Schulz, Gerhard; Strack, Thomas; Beyer, Jürgen; Krause, Ulrich; Cordes, Uwe; Weber, Thomas; Nagel, Joachim H.; Beutelspacher, Friedrich
    The metabolism of insuIin-dependent diabetics (lDDs) cannot always be normalized by the conventional subcutaneous insulin regimen that usually provides only two Injections of reguIar and intermediate-acting insulin per day, but glucose-controlled intravenous insuIin infusion ensures almost normal glycaemia all day long. However, glucose-controlled insulin infusion systems (GCIIS) are available only for inpatient treatment because, at present, in vivo glucose measuring systems are not suitable for portable devices. Thus only open-loop devices are considered for outpatient treatment for brittle IDDs. There is no difficulty in findIng the right dosage for the basic insulin requirement, but control of the postprandial blood glucose increase presents a greater problem since the preprandial blood glucose level should be restored within two hours postprandially, without rlsking severe hypo- or hyperglycaemia. It Is obvious that insulin dosage alone is insufficient for this, but the timing of the insulin infusion may be important. The aim of this study was to clarify the importance of different insulin infusion profiles on daily and postprandial blood glucose levels.
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    Development of individual insulin infusion profiles for open loop infusion systems
    (1984) Strack, Thomas; Krause, Ulrich; Schulz, Gerhard; Beyer, Jürgen; Beutelspacher, Friedrich; Nagel, Joachim H.
    The computer program for the open loop infusion device simulated the feed-back structure of a closed loop insulin secretion control by an algorithm based upon a theoretical postprandial blood sugar profile. Fifteen unstable juvenile onset insulin requiring diabetics could be well controlled after two to three days of an intravenous open loop insulin infusion program. The programs consisted of two constant basal rates and superimposed wavy step profile programs activated at the beginning of each meal.The preabsorptive bolus or cephalic phase was an additional tool both for improved postprandial blood sugar control and further reduction of insulin consumption.The programmable insulin infusion device proved as a valuable tool for the study of a sophisticated insulin infusion profile suitable as well for open loop as for closed loop insulin infusion systems.
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    Der Einfluß verschiedener Insulininfusionsprofile auf Blutzuckerführung und Insulinverbrauch bei der Therapie von Typ-I-Diabetikern mit nichtrückgekoppelten, portablen Insulininfusionssystemen
    (1983) Strack, Thomas; Schulz, Gerhard; Beyer, Jürgen; Krause, Ulrich; Nagel, Joachim H.; Beutelspacher, Friedrich
    Der Stoffwechsel insulinpflichtiger Diabetiker kann nicht immer durch die konventionelle subkutane Therapie befriedigend eingestellt werden. Blutzuckerkontrollierte Infusionssysteme hingegen sind zur Zeit nur für die klinische Diabetestherapie verwendbar, da in vivo messende Blutglukosesonden für portable Infusionssysteme nicht zuverlässig genug arbeiten. So kommen vorläufig nur nichtrückgekoppelte Insulininfusionssysteme für die ambulante Behandlung des Typ-I-Diabetes mellitus in Betracht. Ein größeres Problem stellt die Kontrolle des postprandialen Blutzuckeranstiegs dar: Der Nüchternblutzuckerwert sollte innerhalb von 2 Stunden wieder erreicht werden, und zwar ohne das Risiko schwerer Hypoglykämien in dieser Zeit. Offenbar ist dies nicht nur ein Problem der Insulindosis, sondern auch eine Frage des Infusionsprofils selbst.